MEDICARE: BENEVOLENCE INDUSTRIES INCORPORATED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QC1500X	Community Health Clinic/Center
2	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1306257324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BENEVOLENCE INDUSTRIES INCORPORATED

Provider Business Mailing Address
First Line	:	934 ATLANTIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-4515
Country	:	US
Telephone Number	:	562-437-1888
Fax Number	:	562-491-1200

Provider Business Practice Location Address
First Line	:	934 ATLANTIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-4515
Country	:	US
Telephone Number	:	562-437-1888
Fax Number	:	562-491-1200

Authorized Official
Title or Position	:	CEO/ PRESIDENT
Name	:	KWABENA OBENG
Credential	:
Telephone Number	:	310-800-7963

Provider Enumeration Date	:	05/13/2014
Last Update Date	:	03/12/2026

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Directions to “BENEVOLENCE INDUSTRIES INCORPORATED ” Practice Location

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